You've Worked Hard to Build This Life. Let's Make Sure It Holds Up.

IRMAA stands for Income-Related Monthly Adjustment Amount. It is a surcharge the federal government adds to your Medicare Part B and Part D premiums if your income exceeds certain thresholds. Think of it as a tax on your Social Security. The more income and assets you have, the higher the surcharge. For high earners, IRMAA can quietly consume a significant portion of their Social Security benefit every month, and most people have no idea it exists until they enroll in Medicare and are immediately informed they will be charged for having a higher income based on reported earnings two (2) years prior to enrolling in Medicare.
‍
Don is an IRMAA Certified Counselor, one of a small number of professionals in the country with that designation, and helps clients plan around this before it becomes a problem in the future, also assisting unsuspecting clients recently ambushed by an IRMAA surcharge when they enrolled into Medicare - Parts B & D..

Social Security is the first place the government reaches to collect IRMAA surcharges. If your income triggers an IRMAA penalty, the surcharge gets deducted directly from your Social Security benefit before it ever reaches you. In the most severe cases, the surcharges can reduce or eliminate your monthly benefit altogether - or worse, by actually billing you for the amount owed that was not covered by your entire Social Security benefit. Planning your income and asset drawdown strategy with IRMAA in mind is one of the most overlooked ways to protect what you've earned.

Yes, in many cases it can be reduced or avoided entirely through careful planning. The income thresholds that trigger IRMAA are based on your Modified Adjusted Gross Income from two (2) years prior, which means there is a window to take action before the surcharge hits. Strategies like Roth conversions, managing retirement account distributions, and structuring income sources correctly can all influence where someone falls on the IRMAA scale.  Don will provide specific strategies to assist you.

Quite possibly. IRMAA is a specialized area that many general financial advisors and insurance professionals don't focus on. It tends to fall through the cracks between Medicare planning and income planning, which means clients who would benefit most from addressing it are often the ones least likely to hear about it. If your current advisor has never brought up IRMAA and you are a high-income earner approaching or in retirement, that is a conversation worth having.

Most people become eligible for Medicare at age 65, and the enrollment window opens three months before the month of your 65th birthday. Missing that window can result in permanent premium penalties that follow you for the rest of your life. If you are still covered by an employer plan at 65, the rules around when you need to enroll change, and getting that wrong is a costly mistake. Don recommends having the Medicare conversation at least six months before turning 65, earlier if possible, to make sure the right plan is in place from day one.

Medicare Supplement plans, sometimes called Medigap, work alongside Original Medicare and help cover costs like deductibles, copayments, and coinsurance. They generally offer broader access to doctors and hospitals but come with a higher monthly premium. Medicare Advantage plans bundle Medicare benefits through a private insurer and often include extras like dental and vision, but they typically come with networks and prior authorization requirements that can limit flexibility. The right choice depends on your health, your finances, and how you prefer to manage your care. Don helps clients compare both options without a bias toward either.

Medicare (and most health insurance) does not cover non-medical long-term care, which is the kind of ongoing help with daily living activities (ADL’s) that many people eventually need. Also, Medicare will not cover long-term cognitive challenges such as Alzheimer’s disease.  Medicare has never covered most dental, vision, or hearing expenses. Routine dental cleanings, eyeglasses, and hearing aids are out-of-pocket expenses for Medicare recipients unless they have supplemental coverage. Many people retire assuming Medicare covers most things and are caught off guard when a major gap surfaces at the worst possible time.

Having significant assets does not eliminate the long-term care risk, it simply means that you will be paying privately - full cost - for the duration of your care.  You will pay to maintain your independence and make certain you receive the care you need in the setting you want.
‍
A prolonged long-term care situation involving two spouses is not uncommon and can deplete even a multi-million dollar estate. Families with no plan other than to pay privately for their care may spend assets that were originally intended to leave for their children or a charity.
‍
However, the answer to the question is really fundamental. People with significant assets always have more choices.  For instance, they may own their home but still choose to insure it against total loss.  Don encourages clients to approach the staggering costs of long-term care in the same manner, reducing the cost of coverage by insuring only the portion that would stress your investments - leaving you more options to remain private pay.

Being declined by one carrier does not mean all options are closed. There are alternative strategies, including hybrid life insurance policies with long-term care riders, annuities with long-term care benefits, and asset-based approaches that don't require the same underwriting standards as traditional policies. Don has spent 30 years specializing in this area and holds a long-term care certification. He knows which tools are available at different health situations and can identify options most people would never find on their own.

Earlier than most people think. The younger and healthier someone is when they apply, the lower the premium and the broader the coverage available to them. Waiting until health issues surface often means higher costs, limited options, or outright denial. Don has seen clients wait too long and lose access to the plans that would have protected them best. The conversation doesn't need to be urgent, but it does need to happen before the door starts to close.

Sequence of returns risk is the danger that a significant market decline in the early years of retirement can permanently damage a portfolio's ability to sustain income, even if the market eventually recovers. When someone is still working and the market drops, they have time to recover. When someone is drawing income from their portfolio and the market drops, they are selling assets at depressed prices to fund living expenses, which accelerates the depletion of the portfolio. Building a floor of guaranteed income that doesn't depend on the market is one of the most effective ways to protect against this risk.

The starting point is understanding what Don calls the envelope test: look at every bill guaranteed to arrive in your mailbox each month and ask whether your guaranteed income sources, Social Security, pension if applicable, and any annuity or dividend income cover them without touching your investments. If the answer is yes, your investments become a choice rather than a necessity. If the answer is no, there is a gap worth addressing before retirement begins. Don helps clients work through that analysis and identify the most efficient way to close any shortfall.

This is one of the most consequential decisions someone approaching retirement can make, and the right answer depends heavily on individual circumstances. Factors like life expectancy, spousal needs, other income sources, health, and tax situation all play into the calculation. Taking the lump sum gives control and flexibility but puts the management burden on the retiree. Taking the monthly benefit provides guaranteed income but may not account for inflation or survivor needs adequately. Don walks clients through both scenarios in detail before they make an irreversible decision.

Completely. Don's approach has always been the same: don't bring your checkbook to the first meeting. That first conversation is about understanding where someone stands, what they're worried about, and whether there's something genuinely worth solving together. Some people walk away with a plan. Some walk away with a referral to someone better suited to their specific need. Some walk away realizing things are in better shape than they thought. All three are good outcomes.

Most financial advisors focus primarily on investment management and accumulation. The areas Don specializes in, long-term care planning, Medicare, IRMAA mitigation, guaranteed income strategies, tax-advantaged wealth transfer and insurance-based protection, often fall outside what a traditional investment advisor addresses. Many of Don's clients have existing advisors they trust and continue to work with. Don fills the gaps those advisors aren't covering. In his experience, the clients most at risk are often the ones who assume their current advisor has everything handled.